2.11.15 Garfield County Public Health year end final

GCaorufinetlyd Public 2H0ea1lth4 Report1

“The greatest reward of the Public Health field is being able to make a difference in the lives of people in the entire community.2

Garfield County Public Health is working to make this We exist to improve health care quality and delivery,difference by building educational programs, developing to influence policy, and to provide information thatpolicies, expanding services, and conducting research promotes health, prevents disease and empowersto improve the health and well-being of the population. people to make sound health decisions.This year, our team has worked on projects ranging This report serves to highlight ways in which our teamfrom improving school lunch menus, to ensuring has made a difference in Garfield County this pasthealthy air and water for our citizens, to monitoring the year. As we move forward, Public Health will continueglobal outbreak of Ebola. to monitor the ever changing needs of our population, and continue to provide the preventative health care Public Health has a responsibility to improve that we need to grow stronger, healthier communities. and protect the health of everyone across all lifespans, from the youngest of infants, to our Yvonne Long senior citizens. Public Health DirectorOur challenge is to find collaborative,2014 Garfield Countymultifaceted approaches to respondto our communities’ unique needs. Public Health 3

ImmunizationsVaccine preventable diseases like whoopingcough, polio, and measles previously have killedthousands of people every year. As vaccines weredeveloped, these diseases became rare. However,rates are increasing among unvaccinated people.If, and when, citizens make the choice not tovaccinate, they put the entire community at riskfor these preventable diseases.This year, 4,352 people in Garfield Countyreceived recommended immunizations throughpublic health clinics. The health department alsoadministered over 2,000 flu vaccinations. Thisis a slight decrease from the past year’s total,because of a vaccine manufacturing delay. Eventhough health care facilities experienced a delay,vaccines were available at private pharmacylocations throughout the community. Through thetravel clinic, 224 people received vaccinations fortravel to foreign countries. 4

Communicable disease prevention The health department monitors local disease outbreaks, alerts clinicians to public health threats, and investigates cases to control the spread of infectious diseases. This year, there were 133 cases of reportable diseases. • 40 percent were food or waterborne diseases • 20 percent were vaccine preventable diseases • 19 people were hospitalized for flu (influenza) • 37 people tested positive for Hepatitis CCGoarufnietlyd2014 Ebola HPueballitch The 2014 Ebola outbreak marked the first time the disease’s spread reached epidemic levels. With the total number of cases exceeding 20,000 worldwide, Garfield County Public Health focused on local preparedness efforts. By hosting mock exercises and coordinating protocols with other response agencies, the emergency preparedness team was able to assess readiness and the ability to handle a local infectious disease outbreak. Emergency preparedness In any type of an emergency where the health of the public is at risk, public health departments must be prepared to respond. Therefore, the preparedness team meets routinely with emergency officials (fire, emergency medical, hospitals, law enforcement, etc.) and local emergency planning committees to practice emergency scenarios, and to review protocols and procedures. 5

Women, Infants Health Care Program for Children with& Children (WIC) Special Needs (HCP)An average of 60 new clients HCP places nurses in contact with families that have children withwere added to the WIC program physical, developmental, behavioral or emotional conditions, andeach month in 2014. This year, who need help coordinating care for their children. HCP nursesWIC provided 1,100 women and tailor services to fit the needs of individual families to ensure thechildren with nutrition information, best possible health outcomes.breastfeeding support, vouchersfor free healthy foods, andreferrals for health care or othercommunity services. In 2014,$800,000 was spent through theWIC program at businesses inGarfield County.2014Garfield County Public Health Baby and Me Tobacco Free Offering free diapers for up to one year, the Baby and Me Tobacco Free program encourages pregnant women to stop smoking for healthier pregnancies and babies. The program enrollment locally doubled in the past year, with 34 women staying smoke-free during their pregnancies. 6

Breastfeeding support Child Fatality Prevention and Review TeamThe benefits of breastfeeding extend well beyondbasic nutrition. Breast milk is all a baby needs The leading cause of child fatalities in Garfieldin the first six months of life, which is why the County is motor vehicle accidents. Loss of anyhealth department has taken on the challenge of child is devastating to a community. The focus ofincreasing breastfeeding initiation and duration the team is to review any preventable deaths andrates. Garfield County is above the state average, explore new prevention strategies.with an initiation rate of 91 percent. Last year, 48clients participated in a peer-to-peer breastfeeding Car seatsupport program, finding the encouragement to safety inspectionscontinue nursing for the health of their babies. Ninety-six percent of parents believe their child safety seats are installed correctly. However, research shows that seven out of 10 children are improperly restrained. Certified Child Passenger Safety Technicians are available through the health department to provide free child safety seat inspections by appointment, and at local health and safety fairs. The department performed more than 200 car seat inspections in 2014. 7

LiveWell Garfield CountyFocused on healthy eating and active living, LiveWellGarfield County had an active second year. The program hadparticipation from community members in each of the county’ssix municipalities.Community gardens yielded over 3,000 pounds of produce.The Gleaning Project requested community members bringproduce that would otherwise be discarded to farmers markets and food pantries forthe needy. This effort increased fresh produce availability in pantries by 90 percentin the summer months, bringing in over 6,000 pounds of fruits and vegetables.With help from LiveWell, one school district revamped its menus to createnew healthier recipes, increasing student participation in school lunches.LiveWell Garfield County also took part in the statewide Get Movin’Challenge, where participants logged their daily physical activity. 8

Cooking Matters and Shopping Matters programs Cooking Matters allows low-income families to work with nutrition educators to gain hands- on experience preparing nutritious foods. The Shopping Matters program doubled this year, as more than 100 women were taught how to stretch their food dollars through selective shopping at the grocery store for healthier foods. Senior wellness Public health nurses provide services at local senior lunch sites that includes everything from blood pressure checks to information on fall prevention. Nurses also provide local tai chi classes for physical fitness. Farmers markets WIC checks are now redeemable at local farmers markets. This enables clients to select the freshest locally-grown produce at these markets to feed their families.Last year, $15,000 in vouchers were redeemed,making 2014 the largest recorded year for voucheruse at farmers markets. 9

Environmental healthEnvironmental health responded to 65 complaintson air quality, water quality, waste management,food safety, and other environmental issues thathad an impact on human health.Air qualityGarfield County’s air has been the subject ofnational news for several years, and 2014 wasno exception. With so much interest in air quality,environmental health has created one of thestrongest local air monitoring programs in thecountry. The department monitors air for pollutantsand tracks trends over time. Live air quality data,including a visibility index, is available on thecounty’s website. 10

Vehicle idling Idling vehicles are a major source of air pollution. Warming up vehicles through idling is not necessary for today’s electronic engines. In fact, it is harder on vehicle batteries and engines, costs more money in gasoline, and spews hazardous pollutants into the air and into the cabs of idling vehicles. The department worked with public entities, including school districts, to craft idling policies for their fleet vehicles. Radon Exposure to radon in the home is responsible for an estimated 20,000 lung cancer deaths in the United States each year. Free radon test kits are available at the health department. This year, environmental health worked with local pediatricians, to integrate radon awareness into children’s well child appointments.11

“After we saw Justin in our middle school Smiles for Studentsdental program, he thanked us for coming to his school. Hewas so grateful to have his teeth cleaned. After we saw him inthe dental chair, he sat up, held out his hand to shake the hy-gienists’ hand, and thanked her for helping him. It was so neatto see a middle school student so appreciative.”– Jennifer, Smiles for Students Dental Program Coordinator CHoemalmthuynities Program Once someone signs up for Colorado Medicaid or Child Health Plan Plus (CHP+) health insurance, it can be tricky navigating the system. A family health coordinator walks clients through the process of finding medical care or supportive community services. They listen to family needs, make home visits if necessary, and ensure that families have the resources they need to be healthy. This year the Healthy Communities Program served more than 1,500 new clients. In addition to serving clients, the Healthy Communities Program works with medical providers to ensure patients make it to scheduled appointments, understand the medical process, and follow through with treatment plans. 12

Reach Out andRead ProgramHaving a parent read aloudis the most important activityfor developing language andearly reading skills. Staffgave out 1,854 new, age-appropriate books to childrenin clinics. Parents are showntechniques for reading totheir children at home. Connect for Health Colorado In its first year, the Connect for Health Colorado Health Insurance Exchange (part of the Affordable Care Act) enrolled 1,026 Garfield County residents for 2014 healthcare coverage. Before healthcare reform, many families were unable to afford health insurance or unable to obtain coverage due to pre-existing conditions. The Affordable Care Act helped to ensure that thousands of people would have access to comprehensive healthcare coverage. Through Colorado’s Medicaid expansion, the number of individuals enrolled iin Medicaid increased by 54 percent.Smiles for Students Program The Federal Department of Health and Human Services selected the region of Garfield, Eagle,More than half of Colorado third graders get and Pitkin County as one of only seven in thecavities that are preventable. Using mobile nation for a study on how state and local healthdental equipment, a team of registered dental departments can aid in increasing health insurancehygienists traveled to 16 schools to provide 1,293 enrollment. Our region was selected because ofmiddle and elementary students with free dental the strong regional collaborative partnerships andcleanings, oral health education, dental sealants, strong relationships with local human servicesand fluoride varnishes. The program identified 330 departments. The region was studied to identifystudents with severe dental needs and referred promising practices and innovative models thatthem to treatment. might be replicated nationwide. 13

Suicide preventionColorado is consistently among the top 10 statesin the nation with the highest suicide rates. Toprevent suicide, we must first understand thewarning signs, and then know how to respond.The Garfield County Suicide Prevention Coalitionoffers free suicide prevention trainings andpartners with mental health groups to talk aboutways of improving our local mental health system. 14

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2014Garfield County PHueballitch When Wyatt was born, he appeared to be a healthy baby boy. However, at just three days old, he was rushed into emergency surgery and had to have 50 percent of his small intestine removed. He was hospitalized for a month, and unable to gain weight. When his mother, Rhianna, came to Garfield County for WIC assistance, she was distraught. Her son was not absorbing nutrients and she was afraid he was not going to survive. On top of that, he now required specialized formula that cost $51 per can. “From the beginning, I was treated so kindly at WIC. The whole team was so warmhearted, always welcoming and offering solutions.” shared Rhianna. “As part of the program, WIC was able to special order the formula Rhianna’s baby needed and provide it to her free,” said WIC Educator Lori Gish. “We listened to what she “The whole team needed, and helped her walk through solutions.was so warmhearted, Her baby is now a healthy and thriving little guy!always welcoming “It’s the wonder of WIC,” continued Lori. “We and offering aren’t doctors, but what we do have is that extrasolutions.” time to really talk to moms and find out what they need, even if it is just a shoulder to cry on.” making a difference! 16